New Client Form

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New Client Form

Pet information #1

We want to learn all about your pet!

Financial Policy Acknowledgement

We thank you for entrusting us with the care of your pet. In order to provide the best possible animal care, we require that all professional fees be due at the time of service. We accept cash and credit cards including Visa, MasterCard, American Express, and Discover. We also accept Care Credit & Scratch Pay.


I hereby authorize the doctor and technicians to administer services and treatment as explained to me by the doctor. I assume all financial responsibility for all charges incurred for the care and treatment of my pet(s). I understand that services are to be paid for when rendered.

At my request, I will receive a written estimate for services beyond routine care, which I may decline for any reason.

Schedule Policy Acknowledgement

At Charm City Veterinary Hospital, your scheduled appointment time is reserved exclusively for you and your pet. Charm City does not overbook appointment times. We believe optimal veterinary care can be provided only if we have enough time set aside to adequately examine and diagnose your pet, then discuss treatment options in detail with you.

We will make every effort to accommodate your scheduling needs. In return, we ask that you help us by keeping your scheduled appointments by arriving on time. If a situation arises that you will be late or not able to attend your appointment, please let us know ASAP. When possible, we ask that you contact us 24hrs in advance. When Charm City Vet receives advanced notice of cancellations, we are able to accommodate other patients needing care. Failure to comply with this policy will necessitate the assessment of the following:

You will receive an email alerting you of your missed appointment and moving forward you will need to pay a $70 deposit to schedule all future appointments. This fee must be paid at the time you schedule the appointment and is subject to forfeiture should you cancel without 24 hours+ notice or do not come to the scheduled appointment.

Late Arrival Policy

Appointments involving clients arriving more than ten minutes late may be considered "Missed Appointments" and may need to be rescheduled. If you think you are going to be late for your appointment, please call us to determine if your late arrival can be accommodated or if you will need to reschedule.


Telehealth/Communication Policy

We pride ourselves on our effective communication with clients, our transparency and upholding your right to information about your pet's health. In order to ensure everyone is contacted in a timely manner we do a great deal of our communication by email and/or text messaging. We do understand some prefer telephone communication as a primary source of contact but wish to highlight that it may not always be a doctor who contacts you. The doctor will place calls to clients based on medical need at his/her discretion. However, if you wish to request a phone call with a doctor, this will be billed as a "Telehealth Consultation" and a fee may be assessed for this call. Fees range from $25 to $55 based on the length and complexity of the concern/s addressed during said call. Each consultation will reserve a spot on the doctor's schedule & by participating you agree to pay the fee as outlined above. Should you miss your scheduled "Telehealth Consultation" you may be required to reschedule based on the activity of the hospital on that day. In some cases, consultation fee may be waived at the discretion of the veterinarian on the case. You will not be billed if a doctor places a call to you that has not been scheduled by you. Payment for telehealth calls will be due at the conclusion of the call and billed to the card on file unless we are directed otherwise.

Additional Comments

Please use the space below to share any additional information about your pet(s) you deem applicable. Thanks!!!